Global Summit on
Healthcare and Nutrition

Biography:

Dr Valeria Freccero. I´m Biochemist graduated from University of Buenos Aires(2013). My first steps in this career were in emergency laboratory (3 years); working there I developed an incredible passion for hematology and nutrition. In 2015 I started working at the national hospital Professor Alejandro Posadas where I began to investigate micronutrient deficiency. In the same year I started my specialization in clinical biochemistry area hematology. I am currently a biochemist specializing in clinical biochemistry in the area of hematology with several presentations of scientific work and a publication in the journal of the Argentine Nutrition Society.

 

Abstract:

Background and objectives: Several reports indicate that concomitant micronutrient deficiencies are common in patients with iron deficiency anemia (IDA). However, in IDA patients’ vitamin B12 or folate deficiency are frequently undiagnosed. The aim of the present study was to estimate the prevalence of combined micronutrient deficiencies in IDA patients and to compare the hematimetric indices between IDA patients with or without concomitant deficiency of vitamin B12 and/or folate.  

Methods: Retrospective study that comprised the revision of 5477 laboratory reports informed during the years 2014-2015 in the Hematology-Anemias section, Hospital Posadas, Buenos Aires, Argentina. Selection criteria were adult patients (>18years), with IDA [hemoglobin (Hb) <120 g/l and ferritin<15ng/ml] and simultaneous measurement of the complete blood count (LH750, Beckman Coulter), ferritin, vitamin B12 and folate (chemiluminescence, Access, Beckman Coulter). 175 patients were eligible. The diagnoses associated with the presence of IDA were obtained through revision of the medical records. Vitamin B12 deficiency was defined as <200pg/ml and folate deficiency as <4ng/ml. Comparisons were made by ANOVA test and Chi-square test.

Results: From the 175 IDA patients (85% female), 44 presented concomitant vitamin B12 deficiency (IDA+B12) and 16 concomitant folate deficiency (IDA+FA). No differences in age, sex distribution, Hb, hematimetric indices and ferritin levels were observed between the groups (p>0.05). The diagnoses most frequently observed in each category were: a) IDA: infectious disease (17%); b) IDA+B12: autoinmune hypothyroidism (40%); and c) IDA+FA: celiac disease (67%). Elderly patients (age>65years) were more frequent in the IDA+B12 group (18%).

Conclusions: In IDA patients concomitant B12 and folate deficiency are frequent (34%) and might be undiagnosed as hematimetric indices cannot discriminate one condition from the other. In conclusion, the presence of microcytic anemia and iron deficiency cannot exclude B12 or folate deficiency; specially, in elderly patients or patients with celiac disease or autoimmune diseases.